I got a penknife and a book on whittling for Christmas from my wife. No, I don’t know what it means either.
Anyway, here’s a thought: If you could give someone with a long-term health problem one thing, what would it be? No, forget the whittling thing - really, what would you give them? No, a cure doesn’t count.
I think it would be power. If you have ever had a long-term, life-changing health problem, anything from depression to arthritis to chronic back pain, you will know you lose the power to live as you would like and the power to do anything about that.
We know because we have worked with lots of people who are losing some part of themselves, and see they often try to bargain with a distracted universe (don’t make me reference this but, yes, Kübler Ross).
Patients may say: “If you just let me live to see my daughter graduate in June, I will go quietly.” Or “If I get out of here this time, I swear I will never drink again.” What people with reduced control of their lives want most is some power.
Yet I wonder if when presented with it as a gift we - and by we I mean the modern patient - can accept it?
The assertion that type 2 diabetes can be cured if overweight patients semi fast on 800 calories a day for a few weeks may prove to give a fascinating insight into patienthood, personal responsibility and the alienating effect of overmedicalisation.
Yes, we need more research - we will get to that in a minute - but, as health professionals, we cannot fail to be really excited by the fact that we can help someone get better from a long-term condition if we can just help them find a way to radically alter their eating habits. Hell, we can cure them.
I’m interested: how do you think that is going to go. I think it might be great for some people. However, for others, I think -well at the risk of sounding like it’s January and it’s raining and I got a book on whittling for Christmas - I think some are going to reach for the crisps and wait for another type of cure. One they don’t have to do themselves.
Am I being cynical? Or is part of our healthcare crisis less to do with provision and more to do with the nature of patient demand: “I want to get better but I want you to do it and I need it by Thursday.”
I know from personal experience that when you have a health problem and someone tells you “if you can just manage to do X, Y and Z it will get better”, it feels like a gift. I also know that for some people it feels like an assault. A demand too far.
I can’t help wondering if the prospective cure for diabetes is a microcosmic view of treatment for long-term conditions over the next 20 years.
And another thing. I understand that Diabetes UK, a charity, is funding research into the relationship between diet and type 2 diabetes. Well done them. The research continues and has emerged largely from Newcastle University.
But I wonder about research funding. This is because it is research that gets funded that changes the world and, to attract funding, research needs to help serve an economic interest - something more than simply doing good.
I wonder if pharmaceutical companies are likely to invest in research that tells us drugs are not the answer. I wonder if knowledge that empowers people might become less worth looking for. I wonder if personal responsibility is a burden.
Mark Radcliffe is senior lecturer, and author of the new novel “Stranger than Kindness”. Follow him on twitter @markacradcliffe